It's that time of year..students are starting to think about what specialties they want to pursue and whether or not they should do an away rotation. What should you do?!
The short answer is: it depends on the specialty. We can really only speak to our specialties (radiology and orthopaedics) since that’s what we know the most about. We would encourage you to speak with your peers, advisors, and mentors about whether you should go on away rotations for your particular specialty. Away rotations are typically done for the more competitive specialties including dermatology, orthopaedics, interventional radiology, ENT, urology, anesthesia, EM (pretty sure it’s required to get a SLO), general surgery, and sometimes OBGYN. However, away rotations can also "open up a region" for any specialty--meaning that if you want to consider another area of the country for residency, an away rotation could help you do that.
The purpose of away rotations is to get to know other programs and allow them to get to know you. Most people do between 2 and 3, depending on what their schedule allows. We’d recommend rotating at the program you are most interested in last or second to last (if you do 3) so that you’ve had more experience by the time you go to that program and you can impress them with your skills and knowledge! If you do well on your rotation and have it early enough in the season, you might be able to get a letter out of it which is great. This is an important part of away rotations and we would suggest taking a moment to speak with one of the faculty you will be working with and letting them know early you would like a letter. They may give you some pointers on their expectations and tips on how to impress them!
Where should you rotate?
This depends on many factors, and all are personal. Are you interested in attending residency in a particular area? Do you want to check out a particular program? Do your research and make sure you choose a program that seems to be a good fit for you. Students are more likely to match at places where they have rotated (in general). It's important to look at both location and the program itself. The best program in the world could be the wrong fit if you feel too far away from friends and family. If you aren’t tied to a particular area or are comfortable with venturing out, do all of your rotations in different parts of the country or places you could see yourself living! Away rotations are a great excuse to see new places and try new things. There's no wrong answer and it just depends on your particular situation.
Keep in mind that away rotations can get expensive so try to take out extra loans if you need to or budget for the rotations in advance. Not only do you have to find housing for a month at a time, but you have to factor in food, driving, etc. A great resource is “Rotating Room” which is a website where medical students and residents can list their residence for rent for rotating medical students. If you’re able to rent from a friend or acquaintance that’s even better.
The budget for each month is mostly dictated by:
1) Lodging costs (be sure to email the program and ask if they have any subsidized options)
2) The potential need to rent a car
3) Your personal budget
Away rotations are a great opportunity to explore your options and learn some helpful skills in the process!
Diagnostic radiology
At least during the time I was applying to residency, away rotations were not required nor necessarily recommended for diagnostic radiology. Since radiology is not much of a “spectator sport,” it’s difficult to show your skills and contribute on a radiology away rotation. However, if you do have a specific situation in which you want to match at a particular program or location, then by all means go for it. Just make sure to shine because it can either make or break you. Interventional radiology is another story though. As it has very much become a surgical field, away rotations are very important to show your skills, especially since it has become very competitive to match into.
Orthopaedics
This will focus on my experience with away rotations in orthopaedics but it can definitely be applied to away rotations in any specialty. Away rotations in orthopaedics are actually designed to help you. You have one month to show a program how hard you are willing to work, how much you can improve when taught, and how much you enjoy orthopaedics. Away rotations are either going to be your best friend or your worst nightmare. The term "audition rotation," is very accurate, so treat each one as a one month long interview. It can be exhausting, but every moment with residents or faculty is one where they are thinking about each time you went above and beyond. Away rotations are great to hone surgical skills, but definitely practice suturing and knot tying before you go on your first one. Also, studying surgical anatomy is an easy way to get "pimp" questions correct and show that you know your stuff.
The single best way to stand out is to work hard (read that again!). This is what programs will remember about you. Did you stay late to help the resident or just want to get out of there early? Did you show up early to bedside procedures with the necessary supplies or did you just wait to be told what to do? The mindset that I always had was this, "if I can make every resident's life I work with easier, then I've done my job." Ultimately, away rotations are both for you to judge the program and for the program to judge you. Your experience on the rotation, good or bad, will most likely be the experience you would have if you chose that program for residency.
VSAS
This is the application system for away rotations. The best thing to get started on early is taking care of your vaccines and titers! This can be tedious and some programs will not even accept an application without these components. VSAS does allow you to see their requirements before it opens, so try to prepare early. Start by deciding where you'd like to rotate and what your non-negotiable preferences in a program are. Then formulate a short list of programs and do your research on the average scores of accepted residents, subspecialties covered, faculty that you'll work with, etc.
How many programs should you apply to? I'd recommend applying to 3-4 programs for every away rotation slot you have. For instance, if you want to go on three away rotations, apply to roughly 9-12 programs total. In my experience, even if you have to turn down an acceptance for an away rotation due to that slot already being filled, it will likely not affect you receiving an interview invitation later on. In the end, have solid reasons for applying to the program, be confident, and do your best!
This was a long one but hopefully we gave you some good insight!
--C&W